HomeMy WebLinkAboutPermit 7678 Greenbrier pg 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: _ - l pi e
le-
PropertyTaxlD#: 3 - %moo - p Lot No
Site Plan Name: D JI = ✓ - ,r� -�� Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
L�
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical — Gas Tank _ Gas Piping
Electric — Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: S
OWNER/LESSEE:
(Affidavit required)
Shutters _ Windows/Doors Pond
_ Generator _ _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic Building Height:
Address: -/&78 p. - '
City: d cSt . t G`- State: Vl
Zip Code: Fax;
Phone No. rJ '70 E
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner lister! above)
CONTRACTOR:
Name:
Company:
Address: r S;
City: _ - 5 r ._. . (� / State: `ram
Zip Code: _3 4G 9 $ 4j Fax:
Phone No '7 - IgILI
E-Mail i S
State or County License-CEa
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.